Causes and Treatments of Moles | Dermatology

Moles

What are moles?

Moles are a common type of skin growth. It often appears as small, dark brown spots and is caused by clusters of pigmented cells. Moles generally appear during childhood and adolescence. Most people have 10 to 40 moles, and some may change in appearance or fade over time.

Most moles are harmless. It rarely becomes cancerous. Monitoring of moles and other pigmented spots is an important step in detecting skin cancer, especially malignant melanoma. The medical term for moles is nevi.

Types of moles

Congenital moles are the ones present at birth. Congenital moles occur in about 1 in 100 people. These moles are more likely to develop into melanoma (cancer) than moles that appear after birth. A mole or freckle should be examined if its diameter is more than a pencil eraser or any features of ABCDE melanoma (see below).

Unusual moles that may indicate melanoma

The ABCDE guide can help you determine if a mole or macula indicates melanoma or other skin cancers:

  • A is for the asymmetric shape: half as opposed to the other half.
  • B indicates border: Look for moles with irregular, jagged, or squamous borders.
  • C for colour: Look for flushes that change colour, have many colours, or have an uneven colour.
  • D for diameter: Look for new growths in a mole larger than 1/4 inch (about 6 mm).
  • E for development: Monitor moles that change in size, shape, colour, or height, especially if part or all of the mole has turned black. It may also develop to present new signs and symptoms, such as itching or bleeding.

Cancerous (malignant) moles vary greatly in appearance. Some may display all of the above features. Others may only have one or two.

Dysplastic nevi are moles that are generally larger than average (larger than a pencil eraser) and are irregular in shape. They tend to have uneven colours with dark brown centres and uneven lighter edges. These birthmarks are somewhat more likely to become melanoma. In fact, people who have 10 or more dysplastic nevi have a 12 times higher chance of developing melanoma, which is a serious form of skin cancer. Any mole changes should be examined by a dermatologist to evaluate for skin cancer

What are the symptoms of moles?

A typical mole is a brown spot. Actually, they come in various hues, shapes, and sizes:

  • Colour and Texture: Moles can be brown, tan, black, red, blue, or pink. It can be smooth, curly, flat, or raised. They may have hair growing from them.
  • Shape: Most moles are oval or round.
  • Size: The diameter of the mole is usually less than 1/4 inch (about 6 millimetres) – the size of a pencil eraser. In rare cases, they present at birth (congenital birthmarks) can be much larger, covering large areas of the face, trunk, or limb.

They can appear anywhere on your body, including the scalp, armpits, under your fingernails, and between your fingers and toes. Most people have 10 to 40 moles. Many of these species develop by the age of 50. The appearance of moles may change or fade over time. Hormonal changes during adolescence and pregnancy may cause moles to become darker and larger.

What causes of moles?

Why a new mole appears in adulthood is not well understood. It may be benign or cancerous. The causes of skin cancer have been well studied, but there is little reliable research on the causes of benign moles.

Gene mutations are likely to be involved. A 2015 research study reported that genetic mutations of the BRAF gene were present in 78 per cent of a reliable source of benign acquired moles. BRAF mutations are known to be implicated in melanoma. But the molecular processes involved in converting a benign mole into a cancerous mole are not yet known.

The interaction of UV rays, both natural and synthetic, with DNA, is known to cause genetic damage that can lead to skin cancer and other skin cancers. Exposure to sunlight can occur during childhood or youth, and only long afterwards can it lead to skin cancer.

Causes you may have a new mole include:

  • Increased age
  • Fair skin and light or red hair
  • A family history of atypical moles
  • Responding to drugs that suppress your immune system
  • Responding to other medications, such as some antibiotics, hormones, or antidepressants
  • Genetic mutations
  • Sunburn, sun exposure, or use of a tanning bed

New moles are more likely to become cancerous. A 2017 survey of contextual investigations found that 70.9 per cent of melanomas emerged from another mole. If you are an adult and have a new mole, it is important for your doctor or dermatologist to examine it.

How do dermatologists treat moles?

Most moles do not require treatment. The dermatologist will remove the mole:

  • Bothersome (rubs against clothing, etc.)
  • Unattractive to a patient
  • Suspicious (could be skin cancer)

A dermatologist can eliminate a mole during an office visit. Most removals require only one office visit. Occasionally, the patient may need to return for a second visit.

Whether it is during one or two visits, a dermatologist can remove a mole safely and easily. A dermatologist will use one of these procedures:

  • Surgical excision: The dermatologist cuts the entire mole and stitches the skin if necessary. The mole will also be examined under a microscope by a specially trained doctor. This is done to check for cancer cells. If cancer cells are found, your dermatologist will tell you.
  • Surgical shave: A dermatologist uses a surgical blade to remove the mole. In most cases, a specially trained doctor will examine the mole under a microscope. If cancer cells are found, your dermatologist will tell you.

Never try to remove a mole at home

While it may seem more appropriate to shave or cut a mole yourself, there are three very good reasons a dermatologist should remove it:

  • Skin cancer: If the mole contains skin cancer, some cancer cells can remain in the skin and even spread.
  • Scarring: You can mar your skin causing a scar.
  • Infection: A dermatologist uses sterile equipment to prevent infection.

Outcome

After the mole is removed, the skin heals. If the mole grows again, make another appointment immediately to see a dermatologist. This could be a sign of melanoma, which is the most dangerous type of skin cancer.

Diagnosis

Since nevus are so common and melanomas are uncommon, preventive removal cannot be justified. However, biopsy and histological evaluation should be considered if nevus have specific characteristics of concern (known as ABCDEs of melanoma). If a mole becomes painful, itchy, bleeds, or sore, a biopsy may also be considered.

The biopsy test ought to be profound enough for precise minute finding and ought to contain the whole injury if conceivable, particularly if the worry about malignant growth is solid. However, extensive primary resection should not be the initial procedure, even for highly visible lesions. Many of these lesions are not melanomas, and even with melanoma, an appropriate treatment margin is determined and lymph node sampling is recommended based on histopathological features. Excisional biopsy does not increase the risk of metastasis if the lesion is malignant, and it also avoids extensive surgery for the benign lesion.

Is it possible to prevent moles?

Since we cannot change our genes, not all nevus can be prevented. The following preventive measures focus on sun avoidance and sun protection include:

  1. Use sunscreens with SPF (sun protection factor) 50;
  2. Use wide-brimmed hats (6 inches);
  3. Use of sun-protective clothing (shirts, long sleeves, long pants);
  4. Avoid peak sun hours from 10 AM to 4 PM;
  5. Find shade and stay indoors.

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